Back surgery can correct a structural problem, but it can’t guarantee complete or lasting pain relief. Around 20% of patients continue to experience pain after the expected recovery period or initially improve but develop new or recurring symptoms months or years later.
This issue is known as failed back surgery syndrome (FBSS). However, it was recently renamed to persistent spinal pain syndrome because the FBSS name can be misleading.
It doesn’t necessarily mean that the surgeon or procedure failed; surgery may successfully stabilize your spine or relieve nerve compression while another issue continues to cause back pain.
At North of Atlanta Pain Clinic in Duluth, Georgia, we investigate what’s driving your symptoms and use nonsurgical or minimally invasive treatments to help you move forward.
Your spine contains vertebrae, discs, joints, ligaments, muscles, and nerves. Surgery may address one damaged structure, while other tissues still generate pain.
Possible causes of persistent or recurring symptoms include:
Preoperative risk factors for FBSS include smoking, obesity, and mental health conditions.
Pain may resemble your original symptoms or have a different character. Some people experience a dull ache in their lower back, while others develop burning, tingling, electric-shock sensations, numbness, or pain that travels into a leg.
Persistent pain doesn’t automatically justify another operation. Before recommending treatment, we need to determine whether your symptoms come from a correctable structural problem, an irritated nerve, a painful joint, or another source.
We review your surgical history, current symptoms, and previous treatments. A physical examination helps us assess your strength, sensation, reflexes, and movement. MRI, CT, X-ray, or electrodiagnostic testing provide additional details.
Diagnostic injections can also help us identify the source of your pain. For example, temporarily numbing a particular nerve or joint can indicate whether that structure contributes to your symptoms.
Urgent surgical assessment may be necessary if you have severe spinal instability, new or increasing weakness, or loss of bladder or bowel control. However, many people manage persistent pain without undergoing another major operation.
Spinal injections deliver medication directly to the suspected source of your pain. An epidural steroid injection may help when inflammation around a spinal nerve causes back or leg symptoms. Selective nerve root blocks target a particular nerve, while facet or sacroiliac joint injections address pain coming from those joints.
We use fluoroscopy, a form of real-time X-ray imaging, to guide the needle accurately. Injections don’t reverse every cause of postsurgical pain, but they may reduce inflammation enough to improve movement and make physical therapy more manageable.
If diagnostic medial branch blocks show that small nerves around the facet joints carry your pain signals, radiofrequency ablation may provide longer relief. During this minimally invasive procedure, we use controlled heat to disrupt the targeted nerves’ ability to transmit pain.
The nerves can regrow, so the results aren’t necessarily permanent. However, a period of reduced pain can help you be more active, rebuild your strength, and participate more fully in rehabilitation.
Spinal cord stimulation offers another approach for chronic pain that hasn’t improved with medication, therapy, or injections. It can prove particularly useful for persistent neuropathic pain — the burning, shooting, or electric pain associated with irritated or damaged nerves.
A spinal cord stimulator sends mild electrical signals to your spinal cord. These signals modify pain messages before they reach your brain. The treatment doesn’t remove scar tissue or repair a damaged disc. Instead, it changes how your nervous system processes pain.
One important advantage involves the trial stage, where you use temporary leads connected to an external device. This trial allows us to assess whether stimulation meaningfully reduces pain and improves function before considering a permanent implant.
Pain relief forms only one part of recovery. Long-term improvement may also require:
You don’t have to assume that persistent pain means another major operation. We evaluate the cause of your postsurgical pain and offer interventional treatments that deliver genuine relief.
Contact North of Atlanta Pain Clinic today to schedule an evaluation and learn how a nonsurgical pain management plan could help you reclaim function and take back more of your daily life. Call our office at 770-559-8385 or click here to book your appointment.
